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Any options out there besides fusion??

TneitzelTTneitzel Posts: 39
edited 06/11/2012 - 8:56 AM in Back Surgery and Neck Surgery
Hi, I am 22 years old. I have had two failed back surgeries in the last six months. The first being in the form of a microdiskectomy on 4/19/11. A month after that I had no improvement with my right leg pain what so ever and I also had left leg pain which was odd because I had never had that. The surgery was done at the L5 S1 level. I talked to my surgeon while reviewing my MRI result and he said that I had not re herniated the disc but I had disc fragments and a bone spur on the left side?? He said the pain would not go away without another surgery. So I had a Decompression/revision at the same level on 5/20/11. The recovery was and still is very long and brutal. I awoke from the surgery with horrendous muscle spams in both legs, which took the nurses an hour to get doctors orders to give me a valium shot which eventually helped. It is now the middle of September and I am still in a great deal of pain. I found out on August 24th after having a third MRI that I have a re-current disc herniation at the L5 S1 level and moderate to advanced disc degeneration at the same level as well. I was devastated when I heard this news I had no idea how it happened. I got a letter from my surgeon reminding me that there was no guarantee with the surgery and that He doesnt recommend surgery at this point rather a core strengthening excersize program which I have been doing for at least a month now, also that if the pain does not get better in a year he would want to do a L5 S1 diskectomy and Front-back fusion on me. First of all there I do not want to have to go down that road, I am way to young to get a fusion. Second there is no way in hell I am letting him cut me open a third time. A few days ago I met with an orthopedic surgeon at the University of Minnesota and he said that I should give the core strengthening another three months and If it does not help he would recommend doing the fusion then. He also informed me that the success rate of the fusion was about 60% and that the success rate of the two surgeries I had were about 95%. This makes me feel like there is no way a fusion will work on me! I dont know what to do. Is there anyone out there who can shed some light on this, maybe some one who has gone through a similar situation? any help would be greatly appreciated. I am too young to let this happen but if it comes down to it I guess I have no choice. I also was wondering about an ADR? The surgeon at the U told me I would not be a candidate for that due to all of the scarring that has been done to my tissue and disc. any one know anything about that? My primary doctor told me that I would be a candidate for one, I dont know who to believe! This is soo frustrating, any one out there got any advice on what I could do besides A fusion?? Thanks- Thomas


  • I would get a couple more opinions. My NS doesn't recomend most discetomy's he says the reason is exactly what has happened to you.... If it works long term great. He just happens to do a lot fusions for failed discectomy surgery.

    Could it be your problems was not solved because the surgeon did not address the problem behind the issue. Perhaps you have spinal instabilty that has yet to be discovered?

    My NS gave me a 80-85% success rate on his lumbar fusion. I have had excellent results. Had I done the microdiscectomy that a different dr recomended I would have wasted a lot of time and money.

    Again- I would get some other opinions. Are you a candidate for ADR? Maybe that is an option for you?

    Good luck,

  • I would much rather do an ADR but the surgeon said that I would be un able to do that as there is too much scarring and damage from my previous surgeries. I would much rather do ADR since it is less invasive and less healing time for a fusion. Also is there anyone out there who could tell me there who could tell me from their expirience's what the ball park recovery time for a ALIF fusion is?
  • I had a minimally invasice alif in Dec. It healed up great. Fused in end of April. Are you in Mn?
  • yes I live in southern MN. Where are you located?
  • Hey there, so sorry you haven't had success yet. Why won't they do a revision MD? Just asking. I know typically they will only do that surgery twice but seems like in your case, the 2nd time was really to clean up non-disc material.

    The stats your surgeon gave are slightly off from what I was told/read. The first MD does have about a 90% success rate. But I heard the 2nd time it drops to something like 80% which was not much different than the 70% odds the fusion gave me.

    I had a revision as well but did get some relied on the leg pain. I still have all the numbness but I did get a bit os leg strength back. I also have a lot of back pain though with strength training can manage. The strength training under proper supervision can help.

    As for fusion, I would get a few opinions. I only say this because you want to understand why a 360 fusion v.s. TLIF/PLIF.

    Sounds like this new doctor might be on the same though process you are. Conservative is better. I am like you, trying to avoid a fusion. If you can "buy" time until ADR is more of an option for you.

    On the flip side, if a fusion works, I do know a few folks that have been better (not 100%, but better) for almost 20 years.
  • ADR- Articial Disc Replacement :)
  • tony {UK}
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • DNice. Thanks for the response. I guess the reason why they cannot do another MD or Lami revision is because of the amount of bone from my lamina that they would have to take out and the amount that has already been taken out. At this point I have had two doctors say that my pain is not coming from the re hernitaiton its self(being that its so small and not pressing on the nerve roots) but rather from the degenerative disc. I do at least a half hour of core strengthening a day and PT 2-3 times per week. That hasnt helped at all so far, the only way to somewhat manage my pain is by taking narcotics I take 5-6 10mg hydrocodone a day and am also on the 50mcg per hour fentanyl patch which only helps me with soreness in the mornings. I also take 600mg of Gabapentin at bedtime. My therapist said that what she is having me do know is not going to fully help me and that I should go to a MEDIX? program, not quite sure what that is. I have also looked into a non-surigcal procedure called Neuro-Spinal decompression which supposidly is a good way to treat degenerative discs and also patients who have had multiple failed back surgeries. Does any one know anything about the NSD treatment?
  • Hi there...PT exercises didn't do a heck of a lot right away. They really helped with body mechanice while I was going. I definitely had an easier time (less pain afterward) by the 5th and 6th week. After than I made a promise to myself to keep up the exercises at home. That's what helped. I would say it took another 6 weeks or so to see improvement. I am now able to walk on my toes and push up. I do get set backs in regards to leg pain and muscle spasmsn but they seem to be more manageable now.

    I'm not familiar with NSD treatment. You might want to start a separate thread to ask OR see if you can enter that in the 'search' box.

    Anything the therapist recommends, make sure you check with your surgeon just to be sure it's not doing more harm than good.
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